Nexus of Good: Initiative for holistic health

Sampoorn Swasthya Karyakram is a concerted effort aimed at addressing the unique health needs of tribal students in Madhya Pradesh. The Department of Tribal Affairs and the National Health Mission (NHM) under the Department of Public Health and Medical Education, have collaborated to launch a special programme. This programme, administered through the Rashtriya Bal Swasthya Karyakram (RBSK), prioritises the health and well-being of students within tribal communities. A cornerstone of this initiative is the implementation of a digital health record system, facilitating continual follow-up and monitoring of students' health statuses. Additionally, the programme emphasises capacity building for teachers, empowering them to recognise and respond effectively to health-related concerns among their students. By integrating healthcare into the education system and leveraging technology for comprehensive health management, this collaborative effort aims to improve health outcomes and educational experiences for tribal students in Madhya Pradesh.

The need for additional health-related initiatives for students in tribal schools and colleges of 89 Tribal Blocks across 20 districts in Madhya Pradesh is underscored by concerning health indicators revealed in data from sources such as the National Family Health Survey (NFHS) and other relevant studies.

1. High prevalence of malnutrition and anaemia: NFHS data often highlight alarmingly high rates of malnutrition and anaemia among tribal populations, including students. These conditions not only impair physical health but also hinder cognitive development and academic performance.

2. Limited access to healthcare services: Many tribal communities reside in remote areas with limited healthcare infrastructure. This geographical barrier exacerbates health disparities and impedes timely access to medical care for students.

3. Prevalence of infectious diseases: Infectious diseases, such as malaria, tuberculosis, and waterborne illnesses, are often more prevalent in tribal regions due to poor sanitation and healthcare access. This puts tribal students at higher risk of illness and absenteeism.

4. Lack of mental health support: Mental health issues are often overlooked in tribal communities, leading to undiagnosed and untreated conditions among students. Additional initiatives addressing mental well-being are crucial for overall health and academic success.

5. Preventive healthcare focussing on hygiene and health education: Promoting hygiene practices and preventive healthcare measures can significantly reduce the burden of diseases among tribal students. Initiatives focusing on hygiene education, vaccination drives, and regular health check-ups are essential.

Considering these data-driven justifications, it is evident that additional health-related initiatives tailored to the specific needs of students in tribal schools and colleges are essential. Behind this entire initiative the special efforts from the State Leadership, Pallavi Jain Govil, the then Principal Secretary Department of Tribal Affairs, Madhya Pradesh, and Priyanka Das, Mission Director of National Health Mission, Madhya Pradesh, joined hands to prioritise improving healthcare access, addressing malnutrition and anaemia, providing mental health support, and promoting preventive healthcare practices to ensure the holistic well-being of tribal students in Madhya Pradesh.

In addition to the above services, the initiative also encompasses the Digital Health Record Tracking of these students to ensure continual care and well-being. Eventually, the holistic approach towards the health of these students not only helps in the overall cognitive development of each child but also empowers the entire Tribal Community to achieve “Health for All”.

The programme was devised around the National Rashtriya Bal Swasthya Karyakram. Under the mandate of the RBSK Programme, the Mobile Health Team comprising of 2 Ayush Medical Officers (a male AMO and a female AMO), ANM and a pharmacist annually visit the school to conduct the head to toe physical examination of each student using the MHT kit along with testing for haemoglobin using digital haemoglobinometer and conducting solubility test for Sickle Cell Anaemia. The head-to-toe examination covers identification of the 4Ds (Disease, Defect, Deficiency and Developmental Delay). The age group of children addressed under the Sampoorn Swasthya Karyakram is 5-18 years of age. The health record of each child is captured in the RBSK Portal developed by the Government of India, which clearly enlists the children identified with the 4Ds. The list is handed over to the school teacher, who then follows up for further evaluation, treatment, or therapy in the linked hospitals of the respective blocks where the school is located, with the help of the Block Medical Officer.

School teachers have been trained to identify common childhood diseases and, with the support of the MHTs, contact the Block Medical Officers to streamline referrals to the appropriate facility and treatment provisioning. In addition to these efforts, the school teacher is responsible for maintaining the health of the child and following up on the treatment by linking the school with the Community Health Officer posted in the adjacent Ayushman Arogyam Mandir. The CHO posted at the Ayushman Arogyam Mandir supports the teacher in providing for the primary health needs of the children, maintaining the growth record of each child, counseling on geographic and local nutritional dietary diversity and lifestyle modifications, and consulting with specialists through Teleconsultation Facilities whenever required.

The programme has made remarkable progress so far. Out of a total of 2009 tribal schools, 1952 have been visited and more than 4 lakh children enrolled. More than 3.9 lakh children had been screened till April 2024. Attempts have been made to address all medical-related issues. Interdepartmental coordination meetings at all levels were conducted to develop a force of teachers oriented to understand childhood diseases and address them accordingly.

Taking experience from the positive outcomes in the last year, the Department of Tribal Affairs is planning on issuing a Health Card for each child along with its digitisation. This health card will be maintained by the school principal as a means of regular growth monitoring by conducting anthropometry and informing the parents regarding the growth of the child, including developmental milestones. This health card will be issued annually, and a copy will be shared with the parents for follow-up. This health card will additionally provide an understanding of the importance of nutrition and supplementation in the overall physical and mental development of the child.

Implementing a holistic health programme tailored to enrolled students of tribal schools is essential for overall well-being. Such a programme can empower students to thrive academically and personally by addressing physical, mental, emotional, and cultural aspects of health. It fosters a supportive environment that respects indigenous traditions while providing access to comprehensive healthcare services. Ultimately, investing in holistic health initiatives for tribal school students not only improves their quality of life but also contributes to building healthier, stronger communities for generations to come. The highlight of the entire programme is the linkage established by the School Teacher between the community by engaging with parents and the Department of Health for provisioning of curative and therapeutic care. This model presents a wonderful example that can be replicated in other parts of the country in the true spirit of Nexus of Good.

Views expressed are personal